Migraine in children -childneuroconsult

Migraine in children :Does if affect children and does lifestyle matter?

Yes, Migraine does affect children. It affects 2% of five year olds and 18% of 13-14 year olds. Migraine in many children can go undiagnosed due to unawareness on the part of parents and sometimes doctors. This can lead to significant negative impact on the child’s social wellbeing, scholastic achievement and self-esteem.

Migraine in children

Migraine in children differs from that in adults in many ways. The migraine attack in children is shorter and usually involves nausea and vomiting. Excitement, stress and anxiety can trigger an attack. This is evident by the fact that children tend to have increased attacks of migraine headaches before and during exams. Children with migraine tend to take many days off school. Unlike, Diabetes and asthma, school staff are not well aware of this condition in children. If symptomatic treatment for headaches is not given at the start of migraine, it results in longer and more painful attack.

What are the symptoms of migraine?

migraine-symptoms-in-children

Migraine is more than a usual headache. The child may vomit, and have aversion to light and noise during the attack. He or she may want to lie down and switch off all the lights before going to sleep. Sleep usually makes one feel better. Sometimes, migraines are preceded by an aura. The child feels strange, has problems with speech, and sees patterns of lights or lines. These symptoms may last up to an hour, followed by the typical migraine. Sometimes, the aura may present by itself with no migraine symptoms.

Migraines can be debilitating and can cause deterioration in a child’s productivity and learning. Prevention of migraine is the best form of management. Firstly, triggers have to be identified. Triggers are different for everyone and more than one trigger may actually cause a migraine for an individual. It is of utmost important to keep a diary and make a note of the events that have occurred before your migraine, including the intensity and duration of the attack. Once you start to identify constant triggers associated with your migraine, you will also learn to manage them better.

What causes a migraine?

The common triggers in your life that may initiate or contribute to your migraine are your daily routine, stress, eating, drinking, exams, menstrual periods, hormonal changes, exercise, computers, drugs, alcohol and contraception.
Your headache diary will help you identify the ones that are contributing to your migraine.

Keeping a constant routine in your day helps reduce migraine attacks. However, it is difficult to achieve this in the adolescent’s life which includes college, friends, homework, parties and sports. Your diary will help identify the change in routines that trigger your migraine. This may be, missing breakfast or sleeping late at night. You should try and maintain your usual meal times and do not skip meals. Certain foods like cheese, chocolate and coffee may be contributing or triggering your headaches. Your diary will help you identify these and avoid them appropriately. You should be drinking at least 1.5 litres of clean water every day. Dehydration is one of the major causes of headaches and is one of the most common triggers. Stress can trigger headaches and this is common in teenagers. If you are stressed, you should talk to someone about it. This may be your parents, friends or teachers. Organizing your day and getting help from your close ones may help reduce your stress and thereby the frequency of your headaches. Exam times are very stressful to most. Its best to plan your studying times and make sure you’ve got breaks in the plan. If you are using the computer, it’s best to get away from it for 15 minutes before coming back to it. Sometimes your migraine may start after a routine of exercise; exercising regularly and making it a part of your daily routine can reduce this. Remember to drink plenty of water during exercises. Teenagers go through a really difficult time as they pass through puberty. During this period the hormones are all over the place. Girls usually have increased symptoms before or during their menstrual period and this can be identified using a headache diary. Once a link has been identified, they could prepare themselves for these typical headaches and control them better. An important aspect of a teenager’s life is their lifestyle for pleasure and entertainment. Use of alcohol, cigarettes and illegal drugs pose a major health risk along with being a potent trigger for severe migraine headaches. Late nights, poor sleep hygiene and erratic routine can all contribute to migraine in a significant way.

Migraine Treatment

Migraine in children -medicines

Its best to try stopping your attack early if you feel a migraine attack coming. Inform your parents, friends or teacher about your pending attack. Go to a quiet room and lie down. You could take an analgesic like paracetomol or ibuprofen early. Try and sleep for at least a few minutes, this will help you feel better.

There are a number of medications that can be used for prevention of your headaches but they are not guaranteed to work. These can be taken on prescription from your paediatrician. There is an array of medications that can help reduce your headache duration and intensity once it sets in. This is known as ‘symptomatic’ treatment. However, the first and the best way to reduce the impact of migraine on your life is to adjust your lifestyle.

Once you have identified your triggers with the help of the headache diary. You could make simple changes to your lifestyle, which may make your attacks happen less often. This will make ‘you’ feel in control of your life and not your ‘migraine’.

MBBS, DCH, FRCPCH, CCT(UK), MSc (Epilepsy) I am an avid writer, authoring more than 40 peer-reviewed and public health publications. I have presented numerous posters at national and international meetings, and I am currently in the process of co-authoring a book on Pediatric Neurology and one on pediatrics for medical students. I have been a honorary lecturer for medical students at the University Hospitals of Leicester and have been teaching on the National training courses like the Pediatric Epilepsy training courses.

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